Bird flu breaks out of Asia, enters Europe

ALEXANDER G. HIGGINSThe Associated Press

Published Sunday, February 26, 2006

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A German soldier sprays disinfectant onto a bus Saturday at the port of Sassnitz prior to leaving the Island of Ruegen in northeastern Germany en route for Sweden. The first wild swans infected by the H5N1 strain of the avian influenza were found on the German island of Ruegen last week. By Thomas Haentzschel, The Associated Press

GENEVA -- For years after its appearance in 1997 in Hong Kong, the current bird flu virus seemed corralled in a few east Asian countries. But in the past four months, it has spread across Europe and into Africa, bringing to 31 the number of countries with sick birds.

People have caught it in a quarter of those, and just six people outside east Asia have died. The virus is still not easily caught by humans.

Even so, its sudden sweep across continents on the wings of birds has stunned public health officials. And most say they cannot predict where or when this disturbing germ might mutate into a form that could unleash a deadly flu epidemic.

"Anywhere the virus lands," said Dr. Mike Perdue of the global influenza program for the World Health Organization.

For many months, most experts said Asia was the most likely starting point because of its large population and ubiquitous animal markets. And many still believe that. But it's all speculation.

"It could be Asia. It could be somewhere else," said Maria Cheng, a spokeswoman for the World Health Organization.

"Turkey would have been logically a place that you wouldn't want to see it happen because we saw many cases in a short period of time," said Perdue, referring to the frightening spurt of human cases and the deaths of four children in January.

Dr. Scott Dowell of the U.S. Centers for Disease Control and Prevention said it's difficult to predict the spread of the disease in the next few months, because public health officials have little experience tracking a disease spread by migratory birds.

The closest analogy he could think of is West Nile virus, a bird-associated illness that began in Africa and landed on the East Coast of the United States in 1999. Within four years, it had spread to the West Coast.

As to where the virus has the best chance of morphing into a more serious human threat, Nigeria, where many people live close to their chickens, poses a particular threat. Its 800 federal veterinarians lack the support they need to combat the disease, said Dr. Peter Cowen, former director of a WHO coordinating center in veterinary public health.

"What's missing there is the laboratory infrastructure, the field infrastructure that would allow them to get out in the field to get samples, simple things like enough vehicles to get around," he said.

Cowen, an associate professor at North Carolina State University in the United States, believes it may be time to change strategies: Abandon efforts to quarantine and kill poultry flocks and instead focus on vaccinating them.

"We should be giving that some very serious thought," he said.

Currently, each country decides what to do.

"We don't really have a truly global infrastructure to fight this potential pandemic," he said. "When an epidemic moves into a new territory, it means a new member territory asks help from WHO rather than having a centrally coordinated disease control strategy" that all countries follow, he said.

Many governments aren't adequately paying farmers to destroy their fowl, and "you get sick birds in the market," Cowen said.

At the center of concern is the current strain of the bird flu virus -- known as H5N1, which has set records for its spread and deadliness among birds -- both domestic poultry and wild fowl. About 180 million birds have been killed by the disease or slaughtered in attempts to control it, according to the United Nations' Food and Agriculture Organization.

It has remained a relatively difficult disease for humans to catch. In the initial 1997 outbreak in Hong Kong, 18 people caught it and six died, WHO says.

Experts see two likely ways for the virus to change into a strain that could set off a human flu pandemic -- either by mutating so that it becomes contagious among people or by combining with a regular human flu virus in a person infected with both at the same time.